Now, learning to do business with care shift

RALEIGH – Local business leaders watched closely as the U.S. Supreme Court ruled in favor of most of the provisions in the Patient Protection and Affordable Care Act, President Barack Obama’s health care reform laws.

The court with the majority opinion from Chief Justice John Roberts, upheld the individual mandate, which requires every American to have health insurance, or face a penalty. That fine will apply to employers as well, making it one of the more important aspects of the law to business leaders.

David Crump, president of Raleigh-based Employee Benefits Consulting Co., which helps companies buy health benefits, says this was likely the one issue he heard more about than any other from companies with which he works.

Companies might still not offer health insurance because the fines, at least initially, are less than the cost of providing insurance, says John Kenny, a health care consultant with Employee Benefits Consulting Still, those fines are likely to increase over time, bringing them closer in line with the cost of offering affordable insurance.

The fines are intended to offset costs of providing health insurance directly to people who cannot find coverage through their employers.

In North Carolina, more than 1.57 million residents are uninsured which amounts to about 17 percent of the population.

And with more people being covered under the law, it could lead to more primary care, says Dr. Brian Goldstein, UNC Health Care chief operating officer. That means doctors will have to do a better job of coordinating care because more people will be coming through the doors.

Primary care physicians agreed and know that they must play a critical role in providing more complete care to patients.

“Family physicians have long supported health care access for all,” says Gregory K. Griggs, executive vice president of the N.C. Association for Family Physicians. “The law puts a clear focus on prevention and primary care and recognizes the importance of every individual having a medical home.”

Physician offices have already been consolidating, and it’s possible this will happen more now, in an attempt to provide care without duplicating what another physician has already done.

For health insurers, the law means they must accept individuals without regard for preexisting conditions, something that could increase costs for everyone as the pool of insured lives could end up with more health problems. Of course, the individual mandate might see more healthy people join those pools as well, potentially offsetting some of the costs. That, however, has yet to be seen.

“While the debate in Washington will continue, the need to change health care in North Carolina remains,” says Brad Wilson, chief executive officer of Blue Cross Blue Shield of North Carolina, the state’s largest health insurer. “Our focus on finding new ways to expand access to care, improve quality, and rein in rising medical costs for our customers will not change.”

Wall Street initially took the news as good for hospitals and bad for insurers.

Hospital Corp. of America, with its market cap of $12.5 billion, for example, saw an immediate 10 percent increase in its stock price, while Unitedhealth Group Inc., on the other hand, dropped 4 percent.